Fri Mar 11 2022

91 articles - From Saturday Mar 05 2022 to Friday Mar 11 2022

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Guidelines

Guidelines, position statements, white papers, technical reviews, consensus statements, etc…


Meta-analysis

meta-analyses and systematic reviews

Aliment Pharmacol Ther

Meta-analysis: Hepatitis B vaccination in inflammatory bowel disease.

Patients with IBD have a poor serological response after HBV vaccination. HBV screening and vaccination should preferably be done before starting the immunosuppressive drugs.

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Neurogastroenterol Motil

Anal sphincter fatigability in assessing anal incontinence: A systematic review.

Sphincter fatigability, measured by the Fatigability Rate Index, has good discriminating power for anal incontinence. A standardized protocol needs to be followed by future researchers. Graphical Abstract The analysis used six studies with 413 patients to compare Fatigue Rate Index between patients with AI and controls. All studies reported a lower FRI in patients with incontinence and the FRI was significantly lower in patients with AI (standardized mean difference [SMD] 1.636, p= 0.001). Conflicting results were reported on the correlation between FRI and AI symptom scores.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

A novel phenotype-based drug-induced liver injury causality assessment tool (DILI-CAT) allows for signal confirmation in early drug development.

DILI-CAT, a clinically intuitive, data-driven, computer-assisted scoring algorithm, is a useful tool for early detection of drug's hepatotoxicity in clinical drug development.

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Assessment of the role of the Edinburgh dysphagia score in referral triage in a national service evaluation of the urgent suspected upper gastrointestinal cancer pathway.

In a national cohort, the EDS has high sensitivity and NPV as a triage tool for UGI cancer. The CDS offers even higher diagnostic accuracy. The EDS or CDS should be incorporated into the urgent suspected UGI cancer pathway.

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Schizophrenia and risk of new-onset inflammatory bowel disease: a nationwide longitudinal study.

This population-based cohort study demonstrates a significant association between schizophrenia and subsequent IBD development. Patients with schizophrenia develop IBD at a younger age, and the risk increases with inadequately controlled schizophrenia. Physician vigilance and awareness of this correlation will improve IBD diagnosis and management among this vulnerable patient population.

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Clin Gastroenterol Hepatol

Corticosteroids and 5-ASA versus corticosteroids for acute severe ulcerative colitis: A randomized controlled trial.

In this randomized controlled trial, combination 5ASA with corticosteroids did not benefit hospitalized patients with ASUC more than corticosteroids alone. An exploratory signal for a reduced need for biologics at 90 days in the 5ASA group merits further evaluation. gov ID: NCT01941589.

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Earlier Anti-TNF Initiation Leads to Long Term Lower Health Care Utilization in Crohn's Disease but Not in Ulcerative Colitis.

Earlier administration of anti-TNF therapy is associated with reduced downstream health care resource utilization in CD, though these impacts are not evident in UC.

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Optimized Surveillance Intervals Following Endoscopic Eradication of Dysplastic Barrett's Esophagus: An International Cohort Study.

Lengthening post CE-IM surveillance intervals would reduce endoscopic burden after CE-IM with comparable rates of recurrent HGD/IMCa. Future guidelines should consider reduced surveillance frequency.

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Endoscopy

Microbiology of Bile Aspirates Obtained at ERCP in Patients with Suspected Acute Cholangitis.

The vast majority (91.8%) of bile cultures were positive. The susceptibility of E. coli and K. pneumoniae to ciprofloxacin are lower than historically noted. A notable portion of cultures contained pathogenic, drug-resistant organisms. Prior BES is associated with higher frequency of certain organisms and higher frequency of VRE.

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Relevance of polyp size for primary endoscopic full-thickness resection (eFTR) of suspected T1CRCs.

Results In total 136 patients underwent an eFTR for a suspected T1CRC (median size 15 mm, IQR 13-18 mm; 83.1% cancer). Technical success and R0 rates were 87.5% (119/136, 95% CI 80.9-92.1%) and 79.7% (106/136, 95% CI 72.1-85.7%) respectively. Increasing polyp size was significantly associated with R1/x resection (RR 2.35 per 5 mm increase, 95% CI 1.80-3.07, p 20 mm polyps results in a high R1 rate and should not be recommended.

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Gastroenterology

IRAK4 signaling drives resistance to checkpoint immunotherapy in pancreatic ductal adenocarcinoma.

Single cell RNAseq showed myeloid and fibroblast reprograming towards acute inflammatory responses following IRAK4 inhibition. These changes set the stage for successful combination of IRAK4 inhibitors with checkpoint immunotherapy, resulting in excellent tumor control and markedly prolonged survival of KPC mice. IRAK4 drives T cell dysfunction in PDAC and is a novel, promising immunotherapeutic target.

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Gastrointest Endosc

A New Scoring System to Distinguish Deep Invasive Submucosal (T1) and Muscularis Propria (T2) Colorectal Cancer during Colonoscopy: A Development and Global Multicenter External Validation Study (e-T2 Score).

Multivariate analysis identified the following 5 independent predictive endoscopic findings of T2 CRC: deep depression (OR: 2.08, 95% CI: 1.07-4.04), demarcated depressed area (4.40, 1.39-13.9), 4-fold convergency or more (3.41, 1.90-6.11), erosion or white plaque (8.28, 2.77-24.7), and Borrmann type 2 or 3 tumor (8.76, 3.58-21.5). The area under the curve in the receiver-operating characteristics were 0.90 (95%CI: 0.87-0.93) in development cohort, 0.80 (0.76-0.85) in internal validation, and 0.76 (0.69-0.83) in external validation, respectively. We established and validated a new scoring system to differentiate T1b and T2 CRC using 5 simple endoscopic findings.

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Efficacy and safety comparison of scissor-type knives with needle-type knives for colorectal endoscopic submucosal dissection: A post-hoc propensity score matched analysis (with videos).

Scissor-type knives are safer for colorectal ESD. However, they are associated with slower resection speeds compared with needle-type knives.

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Endoscopic Gastric Plication for the Treatment of Weight Regain Following Roux-en-Y Gastric Bypass.

This novel P-TORe technique combining APC with gastric plication appears technically feasible, safe and effective at treating weight regain following RYGB.

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Endoscopic Gastroplasty Versus Laparoscopic Sleeve Gastrectomy: A Non-Inferioirty Propensity Score Matched Comparative Study.

ESG induces non-inferior weight loss to LSG with similar co-morbidity resolution and safety profiles.

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Gut

A faecal microbiota signature with high specificity for pancreatic cancer.

Taken together, our results indicate that non-invasive, robust and specific faecal microbiota-based screening for the early detection of PDAC is feasible.

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A novel unconventional T cell population enriched in Crohn's disease.

We identified and characterised a subpopulation of unconventional Crohn-associated invariant T (CAIT) cells. Multiple evidence suggests these cells to be part of the NKT type II population. The potential implications of this population for CD or a subset thereof remain to be elucidated, and the immunophenotype and antigen reactivity of CAIT cells need further investigations in future studies.

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Oncological outcomes after piecemeal endoscopic mucosal resection of large non-pedunculated colorectal polyps with covert submucosal invasive cancer.

The majority of cases of large non-pedunculated colorectal polyps with covert SMIC following pEMR will have no residual malignancy. The risk of residual malignancy can be ascertained from three key variables PD, LVI and R1 deep margin.

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Hepatology

A hierarchical regulatory network ensures stable albumin transcription under various pathophysiological conditions.

A hierarchical regulatory network formed by master and pioneer transcription factors ensures essential albumin expression in various pathophysiological conditions.

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Concurrent large spontaneous portosystemic shunt embolization for the prevention of overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt: A randomized controlled trial.

In patients with cirrhosis treated with TIPS for variceal bleeding, concurrent large SPSS embolization reduced the risk for overt HE without increasing other complications. Concurrent large SPSS embolization should therefore be considered for prophylaxis of post-TIPS HE.

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Emerging Immunotherapy for Hepatocellular Carcinoma: A Guide for Hepatologists.

The tumor immune microenvironment of HCC has significant immunosuppressive elements that may impact response to immunotherapy. Major unmet challenges include defining the role of immunotherapy in earlier stages of HCC, evaluating combinatorial strategies that employ targeting of the immune microenvironment plus immune checkpoint inhibition, and identifying treatment strategies for patients who do not respond to the currently available immunotherapies. Herein, we review the rationale, mechanistic basis and supporting preclinical evidence, and available clinical evidence for immunotherapies in HCC as well as ongoing clinical trials of immunotherapy.

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Gut microbiota-derived short-chain fatty acids regulates group 3 innate lymphoid cells in hepatocellular carcinoma.

These findings suggested that modifying bacteria, changing SCFAs, reducing IL17A-producing ILC3s infiltration and combining with immune checkpoint inhibitors will contribute to the clinical treatment of HCC.

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Hepatic inflammation elicits production of proinflammatory netrin-1 through exclusive activation of translation.

These results identify netrin-1 as an inflammation-inducible factor in the liver through an atypical mechanism, as well as its contribution to hepatic inflammation.

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The Risk of Variceal Hemorrhage and Pre-Transplant Mortality in Children with Biliary Atresia.

Transplant-free survival at 5 years was 45.1% (40.5-49.6%) in PROBE and 79.2% (74.1-83.4%) in BASIC. Two (2.5%) of 80 participants who had VH died, while 10 (12.5%) underwent transplant within six weeks of VH. The low risk of VH and associated mortality in children with BA needs to be considered in decisions related to screening for varices and primary prophylaxis of VH.

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Inflamm Bowel Dis

A Practical Index to Distinguish Backwash Ileitis From Crohn's Terminal Ileitis in MR Enterography.

Magnetic resonance enterography features of ICV and TI can accurately differentiate BWI from CTI. Two practical indices introduced in this study showed high specificity to distinguish BWI from CTI.

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Comparing Effectiveness of a Generic Oral Nutritional Supplement With Specialized Formula in the Treatment of Active Pediatric Crohn's Disease.

The generic oral nutritional supplement and specialized formulas both had similar clinical effectiveness in induction of remission in pediatric CD. However, there is considerable cost-saving when using a generic oral nutritional supplement.

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Eicosatetraynoic Acid and Butyrate Regulate Human Intestinal Organoid Mitochondrial and Extracellular Matrix Pathways Implicated in Crohn's Disease Strictures.

ETYA regulates ECM genes implicated in strictures and suppresses collagen content and tissue stiffness in an HIO model. HIOs provide a platform to test personalized therapeutics, including small molecules prioritized by perturbagen analysis.

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Role of Energy Metabolism and Mitochondrial Function in Inflammatory Bowel Disease.

The implicated factors seem to affect mitochondrial function or are influenced by mitochondrial dysfunction, which explains many of the hallmarks of the disease. This review summarizes the results of studies reporting links between mitochondria and IBD that were available on PubMed through March 2021. The aim of this review is to give an overview of the current understanding of the role of mitochondria in the pathogenesis of IBD.

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Secondary Indicators for an Evaluation and Guidance System for Quality of Care in Inflammatory Bowel Disease Centers: A Critical Review of the Inflammatory Bowel Disease Quality of Care Center.

The certification of excellence of the IBD units is currently undergoing auditing. The awareness of and appreciation for QoC in IBD is increasing in China, especially through the quality control evaluation program initiated by the IBDQCC, with a higher number of IBD units applying for the next round of certification. Although secondary indicators seem to play relatively minor roles in QoC, they suggest additional requirements for high level centers.

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Ustekinumab and Vedolizumab Are Not Associated With Subsequent Cancer in IBD Patients with Prior Malignancy.

Exposure to ustekinumab or vedolizumab in patients with IBD and a prior history of cancer does not appear to be associated with an increased risk of subsequent new or recurrent cancer.

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J Hepatol

Deleting the ß-catenin degradation domain in mouse hepatocytes drives hepatocellular carcinoma or hepatoblastoma-like tumor growth.

Apc fs-ex15 and ßcat ex3 mouse models both induce growth of tumors that are transcriptionally similar to either well-differentiated and ß-catenin-activated human HCCs or mesenchymal hepatoblastomas.

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Development and validation of a model to predict incident chronic liver disease in the general population: the CLivD score.

Liver disease often progresses silently without symptoms and thus the diagnosis is often delayed until severe complications occur and prognosis becomes poor. In order to identify individuals in the general population who have high risk of developing severe liver disease in the future, we developed and validated a Chronic liver disease (CLivD) risk prediction score, based on age, sex, alcohol use, waist-hip ratio, diabetes, smoking, with or without gamma-glutamyltransferase (GGT). The CLivD score can be used as part of health counseling, and for planning further liver investigations and follow-up.

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Hepatic recruitment of eosinophils and their protective function during acute liver injury.

This is the first study to demonstrate that hepatic recruitment of and protection by eosinophils occur commonly in various models of acute liver injury. The data further provide insights into the mechanism of hepatic eosinophil recruitment. The findings support further exploration of eosinophils as a therapeutic target to treat APAP-induced acute liver injury.

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Performance of routine risk scores for predicting cirrhosis-related morbidity in the community.

Thus, in a community cohort, we assessed the performance of 20 routine risk scores for predicting 10-year risk of a cirrhosis complication event. We show that two routine risk scores in particular - "APRI" and "FIB4" - could be repurposed to estimate an individual's 10-year risk of cirrhosis morbidity. Adding genetic risk factor information to these scores improved performance only modestly.

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Neurogastroenterol Motil

Autoantigen characterization in the lower esophageal sphincter muscle of patients with achalasia.

Tissue-specific ectopic expression of GAD65 and PNMA/Ta2 and active MMP-9, associated with the presence of specific autoantibodies directed against these proteins, might participate in the pathophysiology of achalasia triggering and/or perpetuating autoimmune disease.

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Transpyloric propagation and liquid gastric emptying in children with foregut dysmotility.

TPP during phase III of the MMC correlated with gastric emptying of liquid and its assessment on ADM might predict abnormalities in postprandial gastric function.

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Transvaginal rectocoele repair for the surgical treatment of a "symptomatic" rectocoele when conservative measures fail: A 12 year experience of 215 patients.

The data suggest that TVRR might be a valid option in patients with rectocoele when conservative treatment has failed. Overall patient satisfaction is good, with improvement of ODS symptoms.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Editorial: a paradigm shift in NUDT15 assessment-towards predictive and personalised medicine in Crohn's disease?

Pubmed   Journal   ReadQx 

Editorial: anti-TNF combination therapy for inflammatory bowel disease-one size does not fit all.

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Editorial: infections and hepatic encephalopathy-does the chicken or the egg come FIRST? A novel perspective at the horizon.

Pubmed   Journal   ReadQx 

Editorial: MAFLD and outcome prediction.

Pubmed   Journal   ReadQx 

Editorial: protecting hypoxia-inducible factor-1a and gut integrity with GB004-a promising therapeutic approach for ulcerative colitis?

Pubmed   Journal   ReadQx 

Editorial: suboptimal ultrasound visualisation in patients undergoing surveillance for hepatocellular carcinoma.

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Editorial: therapeutic phlebotomy for iron overload-start with a diagnosis before bleeding.

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Editorial: time to modify practice and use the modified Rutgeert's score.

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Review article: Role of glucagon-like peptide-1 receptor agonists in non-alcoholic steatohepatitis, obesity and diabetes-what hepatologists need to know.

These studies support the use of GLP-1RAs for the improvement of underlying metabolic dysfunction observed in NASH and suggest further long-term phase III trials are warranted.

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Gastroenterology

Gut Microbiota Reprogramming f Tryptophan Metabolism During Pregnancy Shapes Host Insulin Resistance.

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In Memoriam: Emeritus Prof. Dr. Paul Rutgeerts (1948-2020).

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NAFLD and the Gut-Liver Axis: Exploring an Undernutrition Perspective.

Here, we present undernutrition conditions with fatty liver features, including kwashiorkor and micronutrient deficiency (MND). We then review the gut microbiota-liver axis, highlighting key pathways linked to NAFLD progression within both overnutrition and undernutrition. To conclude, we identify challenges and collaborative possibilities of emerging multiomic research addressing the pathology and treatment of undernourished NAFLD.

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Understanding the role of PUFAs in Crohn's disease.

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Hepatology

Low-dose aspirin reduces the risk of HBV-associated HCC even when administered short-term: too good to be true?

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Making child's play of tolerance: Defining the immune-viral interplay during combination entecavir and pegylated interferon therapy for immune tolerant hepatitis B infection.

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The spectrum of primary liver cancers: heterogeneity and continuity. A foundation for diagnosis and treatment of cancer.

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J Hepatol

Immunological Biomarker Discovery in Cure Regimens for Chronic Hepatitis B Virus Infection.

This paper will discuss the importance of sample collection, the assays available for immunological analyses, their advantages/disadvantages and suggestions for their implementation in clinical trials. Careful consideration must be given to ensure appropriate immunological studies are included as a primary component of the trial with deeper immunological analysis provided by ancillary studies. Standardizing immunological assays and data obtained from clinical trials will identify biomarkers that can be deployed in the clinic, independent of specialized immunology laboratories.

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Neurogastroenterol Motil

Direct and indirect mechanisms by which the gut microbiota influence host serotonin systems.

Direct actions of gut microbes, evidenced by studies using germ-free animals or antibiotic administration, alter the expression of key 5-HT-related genes to promote 5-HT biosynthesis. Indirectly, the gut microbiota produce numerous microbial metabolites, whose actions can influence host serotonergic systems in a variety of ways. This review summarizes the current knowledge regarding mechanisms by which gut bacteria act to regulate host 5-HT and 5-HT-mediated gut functions, as well as implications for 5-HT in the microbiota-gut-brain axis.

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Letters&Replies

Letters to the editors and authors’ replies

Aliment Pharmacol Ther

Editorial: a paradigm shift in NUDT15 assessment-towards predictive and personalised medicine in Crohn's disease? Authors' reply.

Pubmed   Journal   ReadQx 

Editorial: infections and hepatic encephalopathy-does the chicken or the egg come first? A novel perspective at the horizon. Authors' reply.

Pubmed   Journal   ReadQx 

Editorial: MAFLD and outcome prediction-author's reply.

Pubmed   Journal   ReadQx 

Editorial: protecting hypoxia-inducible factor 1a and gut integrity with GB004-a promising therapeutic approach for ulcerative colitis? Authors' reply.

Pubmed   Journal   ReadQx 

Letter: the potential link between oesophageal hypervigilance, visceral anxiety, increased swallow rate and oesophageal mucosal integrity-authors' reply.

Pubmed   Journal   ReadQx 

Letter: the potential link between oesophageal hypervigilance, visceral anxiety, increased swallow rate and oesophageal mucosal integrity.

Pubmed   Journal   ReadQx 

Clin Gastroenterol Hepatol

Gift of the ADR.

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Reply to Sonnenberg et al.

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Gut

EUS versus MRCP in patients with intermediate risk of choledocholithiasis: clinical and statistical viewpoint.

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Hepatology

Letter to the Editor: High rate of clinical and immunological response in patients with HCV-associated cryoglobulinemia.

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Others

all remaining publications eg case reports, images of the month, etc…

Aliment Pharmacol Ther

Persistence of treatment in patients with ulcerative colitis who responded to tofacitinib therapy: Data from the open-label, long-term extension study, OCTAVE open.

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Am J Gastroenterol

Correction to: P047 The Crohn's Disease-Health Index (CD-HI): Development and Validation of a Novel, Disease-Specific Patient-Reported Outcome Measure for Clinical Trials.

Pubmed   Journal   ReadQx 

Clin Gastroenterol Hepatol

Net Remission Rates with Biologic Treatment in Crohn's Disease: A Reappraisal of the Clinical Trial Data.

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Endoscopy

A surprising case of a biliary tumor-like lesion.

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Acute colonic diverticular haemorrhage: to band or clip?

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Endoscopic retrograde appendicitis therapy: a starting point for a change of perspective in treating acute appendicitis (and beyond).

Pubmed   Journal   ReadQx 

Endoscopic ultrasonography-guided hepaticogastrostomy with parenchymal metal stent placement.

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Utility of external and internal magnets to facilitate bile duct cannulation by changing the position of the papilla.

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Gastroenterology

A Cecal Surprise.

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A rare cause of haemoperitoneum.

Pubmed   Journal   ReadQx 

A Rare Esophageal Mass.

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Climate Change, Health, and Healthcare Systems: A Global Perspective.

Pubmed   Journal   ReadQx 

For publication as Clinical Challenges and Images in Gastroenterology An Important Mimicker.

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Gastric Polyps in a Patient with Dyspepsia.

Pubmed   Journal   ReadQx 

Hardly Ants-ipated capsule endoscopy finding.

Pubmed   Journal   ReadQx 

Ileum thickening and biliary stenosis in a 26-year-old woman from Brazil.

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Multifocal Small Bowel Intussusception: an unusual presentation of a common problem.

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Multiple Tumors in a Young Patient.

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Subtle trap for the IBD endoscopy central reader.

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Gastrointest Endosc

A risk stratification for nodal metastasis in T1 colorectal cancer after successful therapeutic endoscopy.

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Gut

Finding clues in unexpected places: detection of pancreatic cancer through the faecal microbiome.

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Rare cause of recurrent acute pancreatitis: a double whammy from the pancreas and duodenum.

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Inflamm Bowel Dis

Balsalazide Exposure During the Development of Fertilizing Sperm May Be Associated With Offspring Birth Defects.

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Letter to the Editor: Re-Revisiting the Association Between Inflammatory Bowel Disease and Parkinson's Disease.

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Vancomycin Is Effective in the Treatment of Chronic Inflammatory Conditions of the Pouch.

Pubmed   Journal   ReadQx 

J Crohns Colitis

Disease activity in the final years of life for patients with longstanding Inflammatory Bowel Disease.

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